choad wrote:

Ayup. The Boss keeps her patients out of the hospital whenever possible. Which keeps them healthier and saves great gobs of money for the insurance companies and government. Can't get any of them to pony up enough money so she can hire a social worker. They see it as "You're saving us money can we give you all our patients?" She has 700 homebound patients now, can't afford to lose money on any more than that. It's slowly changing, eventually I think they'll pay her enough to keep doing it and maybe attract others.

I don't know what year that hospitals started pushing people out of bed and out the door as soon as possible but it was at least 20 years ago. I worked in housekeeping in a hospital back in the mid 70's and a pregnancy used to be a three to seven day stay (pamper the new mother, let her catch up on sleep, etc.) Now, unless it's C Section, it's a day or two. Same with surgeries. Get them up and walking and get them out. Go recover at home. This has been a big boon for Nursing Homes who get people that can't or won't recover at home.

A family member recently had a medical crisis relating to kidney failure. When they could not recover at home, began to deteriorate, and no other family was close enough to help, the hospital warehoused them in this hybrid nursing home ward for 3 weeks. This was a quick path to death, they did not treat them properly or adjust the medicine so they could recover enough to take care of themselves. It took an old friend to come in to be an advocate and fight to transfer them to another hospital's rehab facility. They are back from certain demise. The types of nursing homes being developed to cash in on this new trend have to be viewed with a jaundiced eye.

About the time that a night in the cheapest hospital ward cost more than a night in the Ritz Carlton, that's when insurance decided that if you would survive the ride home, out the door you went. But it's not the hospital's fault, or even the insurance company (mostly), but the tort lawyers who decided that every single interaction with anyone from the chief of surgery down to the lady taking your meal choices was a legally actionable event that everyone got gun shy and charged enough to pay their own ginormous insurance bills.

Interestingly, I read a study last year that compared the cost of malpractice coverage for doctors to the total cost of health care and it just is not that high a percentage. And not the largest operating expense burden on doctors except a few specialties. Most doctors can afford the insurance the study said. They did not look at the impact on the hospitals or the companies he inning facilities . But they did point out the same thing many also say, that the major chunk of health care costs go to the middlemen, the high cost of administration and management of health care services.

Johnny_Rotten wrote:

Interestingly, I read a study last year that compared the cost of malpractice coverage for doctors to the total cost of health care and it just is not that high a percentage. And not the largest operating expense burden on doctors except a few specialties. Most doctors can afford the insurance the study said. They did not look at the impact on the hospitals or the companies he inning facilities . But they did point out the same thing many also say, that the major chunk of health care costs go to the middlemen, the high cost of administration and management of health care services.

Yes; that's what I expected as well. Tort reform is a favorite whipping boy and distraction issue to keep the focus away from the people who are really cleaning up in the health care industry. A lot of rice bowls get filled from all of the inefficiencies in the health-industrial complex, and that's why it's so hard to get meaningful reform.

Johnny_Rotten wrote:

Interestingly, I read a study last year that compared the cost of malpractice coverage for doctors to the total cost of health care and it just is not that high a percentage. And not the largest operating expense burden on doctors except a few specialties. Most doctors can afford the insurance the study said. They did not look at the impact on the hospitals or the companies he inning facilities . But they did point out the same thing many also say, that the major chunk of health care costs go to the middlemen, the high cost of administration and management of health care services.

Also referred to as "Mahogany Row". Why run a Not for Profit hospital when you can be exceedingly greedy?

Johnny_Rotten wrote:

A family member recently had a medical crisis relating to kidney failure. When they could not recover at home, began to deteriorate, and no other family was close enough to help, the hospital warehoused them in this hybrid nursing home ward for 3 weeks. This was a quick path to death, they did not treat them properly or adjust the medicine so they could recover enough to take care of themselves. It took an old friend to come in to be an advocate and fight to transfer them to another hospital's rehab facility. They are back from certain demise. The types of nursing homes being developed to cash in on this new trend have to be viewed with a jaundiced eye.

That's very true, when money is the number one concern care deteriorates. The Boss reported a doctor who took his patients off any medication that needed monitoring and or just never monitored. He'd walk in, pull all the charts, make notes, and leave. Never even saw the patients. After the FBI investigation he would walk into their rooms and say hello, not examine them mind you, and go do what he'd always done. Short staffing, low wages so only new nurses work at the place leaving as soon as they can find something better, people who don't care, there are problems in a lot of care facilities. You definitely need someone who cares enough to check on things. I'm proud of the way my wife works, even if it costs me money.

hedgewizard wrote:

Johnny_Rotten wrote:

A family member recently had a medical crisis relating to kidney failure. When they could not recover at home, began to deteriorate, and no other family was close enough to help, the hospital warehoused them in this hybrid nursing home ward for 3 weeks. This was a quick path to death, they did not treat them properly or adjust the medicine so they could recover enough to take care of themselves. It took an old friend to come in to be an advocate and fight to transfer them to another hospital's rehab facility. They are back from certain demise. The types of nursing homes being developed to cash in on this new trend have to be viewed with a jaundiced eye.

That's very true, when money is the number one concern care deteriorates. The Boss reported a doctor who took his patients off any medication that needed monitoring and or just never monitored. He'd walk in, pull all the charts, make notes, and leave. Never even saw the patients. After the FBI investigation he would walk into their rooms and say hello, not examine them mind you, and go do what he'd always done. Short staffing, low wages so only new nurses work at the place leaving as soon as they can find something better, people who don't care, there are problems in a lot of care facilities. You definitely need someone who cares enough to check on things. I'm proud of the way my wife works, even if it costs me money.

I'd send her flowers if I were able, I've been though both the good and the bad and those who work toward the spirit of the effort need to be recognized.

You might be paying more in co-pays than your medication actually costs.

In a new study published Tuesday in the medical journal JAMA, researchers found that out of the 9.5 million claims for prescription medication in 2013, insurance companies charged more than the base price for the drug in 2.2 million cases. Patients were overcharged for generic drugs 28 percent of the time, the study found, and for brand name drugs 6 percent of the time — for a grand total of $135 million in overpayments...

Smudge wrote:

You might be paying more in co-pays than your medication actually costs.

In a new study published Tuesday in the medical journal JAMA, researchers found that out of the 9.5 million claims for prescription medication in 2013, insurance companies charged more than the base price for the drug in 2.2 million cases. Patients were overcharged for generic drugs 28 percent of the time, the study found, and for brand name drugs 6 percent of the time — for a grand total of $135 million in overpayments...

Johnny_Rotten wrote:

Hedge, I may have come into the conversation late, what is your wife's line of work? Just curious who advocates for what.

She's a Doctor. I made more money than she did last year at my blue collar job, without the 20 some employee headache. Normally she should make about twice what I do. Her hobby, taking care of her Viejitos, is keeping that from happening. She tells me she'll pay back all the money I've loaned her. I figure it's like the car she promised me, never gonna happen. I write it off as building good karma, hopefully keeping my excessively fast driving from leading to a burning wreck.

Well, yeah that's the wise viewpoint to take, on the other hand you could just kid yourself that if you crashed and burned that fast car, she could knit you back together with tender kindness while carrying the weight.